Provider Demographics
NPI:1235812280
Name:VALUE RX PHARMACY
Entity Type:Organization
Organization Name:VALUE RX PHARMACY
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO/CFO
Authorized Official - Prefix:DR
Authorized Official - First Name:JASON
Authorized Official - Middle Name:LE
Authorized Official - Last Name:DO
Authorized Official - Suffix:
Authorized Official - Credentials:PHARMD
Authorized Official - Phone:714-769-0504
Mailing Address - Street 1:1665 W BEACON AVE
Mailing Address - Street 2:
Mailing Address - City:ANAHEIM
Mailing Address - State:CA
Mailing Address - Zip Code:92802-1526
Mailing Address - Country:US
Mailing Address - Phone:714-769-0504
Mailing Address - Fax:
Practice Address - Street 1:22 ODYSSEY STE 135
Practice Address - Street 2:
Practice Address - City:IRVINE
Practice Address - State:CA
Practice Address - Zip Code:92618-3193
Practice Address - Country:US
Practice Address - Phone:714-769-0504
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-08-08
Last Update Date:2023-08-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy